Background to this inspection
Updated
24 December 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed the Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We also reviewed the information we already held about the service. This included their registration report and notifications. A notification is information about important events, which the provider is required to tell us about by law. We used all of this information to plan our inspection.
During the inspection.
We spoke with the registered manager and the nominated individual. We reviewed documents and records related to people’s care and the management of the service, which included 2 people’s care plans and medicine records.
We reviewed 4 staff files, which included pre-employment checks. We looked at other documents such as quality assurance and training records.
We spoke to one person who used the service, a relative of a person who used the service on the telephone to receive their feedback about the service. We also spoke to one staff member on the telephone to check if they knew about the people they supported.
Updated
24 December 2022
About the service
Fortune Smiles Service Ltd is a domiciliary care agency and is based in the London Borough of Redbridge. The service provides personal care to people in their own homes. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
The service was supporting 2 people with personal care at the time of the inspection.
People’s experience of using this service
Risks assessments were not robust to ensure people received safe care. Care plans did not include people’s preferences with personal care to ensure they received person centred care. Communication plan did not include how to communicate with people effectively. We have made a recommendation in this area.
People were not supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Robust audit arrangements were not in place to ensure shortfalls could be identified and prompt action taken.
Staff were aware of how to safeguard people from abuse. Systems were in place to prevent and minimise the spread of infections when supporting people. Pre-employment checks had been carried out to ensure staff were suitable to work with people. Medicines were being managed safely. Systems were in place to ensure staff attended calls on time.
Staff had been trained to perform their roles effectively. Staff supervisions were regular to ensure staff were being supported at all times.
People received care from staff who were caring and had a good relationship with them. Staff respected people’s privacy and dignity. People were encouraged to be independent and to carry out tasks without support.
Systems were in place to ensure feedback was received from people on their care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This was the first inspection of the service since it registered with CQC on 7 October 2021.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
The overall rating for the service is Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Fortune Smiles Service Ltd on our website at www.cqc.org.uk.
Enforcement and recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to need for consent and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.